June 4 (Bloomberg) -- The swine flu outbreak has overwhelmed the U.S.health-care system, a report said.

Communication between government agencies and doctors isn't wellcoordinated and the World Health Organization's six-step pandemic-alert scale causes confusion, according to an analysis released todayby the Robert Wood Johnson Foundation, the Trust for America's Healthand the University of Pittsburgh's Center for Biosecurity. Worriedcitizens flood emergency rooms while undocumented immigrants and theuninsured delay getting medical care, the report said.

The H1N1 influenza virus has spread to more than 11,000 people in theU.S. and caused 17 deaths, according to the Centers for DiseaseControl and Prevention, in Atlanta. WHO is at phase 5 of its alertscale, meaning a pandemic is imminent, even as the bug causes littlemore than a fever and cough in most patients. Researchers say it iscritical to address vulnerabilities in the system before a crisisstrikes.

"H1N1 is a real-world test of our initial emergency responsecapabilities," said Jeff Levi, executive director of the Trust forAmerica's Health, a nonprofit organization in Washington, in an e-mailed statement. "The country is significantly ahead of where we werea few years ago. However, the outbreak also revealed serious gaps inour nation's preparedness."

The report includes 10 recommendations for strengthening the public-health infrastructure, including halting job cuts in state and localhealth departments, providing care for uninsured Americans during anemergency and helping health-care facilities prepare for a surge innew patients.

The work was supported by a grant from the Robert Wood JohnsonFoundation, a Princeton, New Jersey-based endowment fund that provided$523.3 million in grants and contracts last year to support healthprograms in the U.S., according to its Web site. The family of RobertWood Johnson started Johnson & Johnson, now the world's largest health-care products company.

To contact the reporter on this story: Catherine Larkin in Washingtonat clarkin4@bloomberg.net.Last Updated: June 4, 2009 10:00 EDT